Monday, September 02, 2013

Sarawak needs doctors, not high-end equipment

KUCHING: Has the federal government got its priorities all wrong with Sarawak and the state’s healthcare?

The Sarawak Malaysian Medical Association seems to think so.

According to its chairman Dr Donald Liew the government should focus on boosting and retaining manpower in the state’s medical and healthcare instead of spending millions on infrastructure.

“There’s just too much emphasis on upgrading hospital infrastructure, equipments, facilities and services.

“A lot of sub specialised care are too expensive and not cost effective to be set up in all hospitals.

“It is pointless to approve thousands ringgit for an implant for instance, when the patient can’t even make it to the hospital due to logistical hindrances.

“We need to re-prioritise and focus on manpower training, deployment, and last but not least retention manpower,” Liew said adding that social welfare funding for patients often did not adequately take into account the logistics issue in the state.

He further pointed out that Sarawak had only one tertiary referral centre in Kuching and that too was lagging because of lack of manpower.

“The hospital in Kuching especially is packed to the brim. The lack of manpower is making things worse as it takes longer to sort the patients out.

“Even with the consultants making visits to the district hospitals, it is only a stopgap measure,” Liew told FMT recently.

He added that a much more cost effective and comprehensive strategy would be to keep patients out of hospitals by ensuring excellent primary and preventive care.

Lack of training opportunities and overwork

Liew was responding to a recent confession by state Assistant Minister of Health Dr Jerip Susil that despite good financial packages for doctors, it was difficult to retain them, including Sarawakians, in the state.

He reasoned that there were many reasons why doctors generally don’t want to work in Sarawak beyond the mandatory term stipulated by the Health Ministry.

“The main reasons are training opportunities but there is also lack of private practise here.

“Fact is there are many issues in our hospitals. Currently the bigger issue is overcrowding and those who are committed to public service are overburdened with too much work. The vicious cycle of a lack of doctors makes it worse.

“When doctors think about lack of manpower and overwork, the tendency is to stay in a more comfortable environment, hence the disinterest in staying on in Sarawak, “ Liew said.

It was recently reported that unlike Peninsular Malaysia which hard a 1: 700 doctor-patient ration, Sarawak’s was 1:1,500. Sarawak’s population is approximately 2.4 million according to the 2010 consensus and they are scattered across 124,450 km2 of land.

According to the state Health Department there are only 1,352 doctors stationed in government hospitals, district and Mother and Child clinics in the state.

The state has two general hospitals – Miri, Sibu – outside of Kuching and 19 district hospitals.

Other facilities serviced by visiting doctors (VMOs) are Sarawak’s three Flying Doctors Service and its two mobile Boat Clinics which service villages along the Baram and Rajang rivers.